Stool-based methylated syndecan-2 test and fecal immunochemical test for advanced colorectal neoplasia screening in the Chinese population: A multicenter randomized noncomparative study.
Yufeng Chen, Jiaxin Li, Kai Gu et al.
✦ AI-curated · Sources linked
In 30 seconds
This multicenter randomized noncomparative study assessed stool-based methylated Syndecan-2 (mSDC2) testing versus fecal immunochemical testing (FIT) for advanced colorectal neoplasia screening among Chinese adults aged 45–80 years identified through community screening. Among 44,475 participants, advanced neoplasia detection rates were 0.53% with mSDC2 and 0.47% with FIT. Colonoscopy adherence after a positive stool test was higher in the mSDC2 group (35.6% vs. 26.4%; odds ratio: 1.59, 95% confidence interval: 1.36-1.87; P <0.001). The authors call for further studies to clarify clinical utility.
Key findings
- Advanced colorectal neoplasia was detected in 0.53% of the mSDC2 group and 0.47% of the FIT group.
- Advanced adenoma detection was 0.43% with mSDC2 and 0.31% with FIT.
- Colonoscopy adherence was 35.6% with mSDC2 versus 26.4% with FIT (odds ratio: 1.59, 95% confidence interval: 1.36-1.87; P <0.001).
Why it matters
Screening depends not only on test performance but also on whether people complete diagnostic colonoscopy after a positive result. In this large community-based Chinese study, mSDC2 was associated with greater colonoscopy adherence, while observed advanced-neoplasia detection rates were similar to those with FIT. These findings inform evaluation of stool-based screening strategies but do not establish comparative clinical utility.
What to keep in mind
The study was noncomparative, and the authors state that improved comparability and longer follow-up are needed to clarify clinical utility.